The temporal stability of maternal parenting style and child feeding practices: A six-wave longitudinal study

Although parenting styles and child feeding practices are conceptualized as distal, static predictors of child eating and weight outcomes, few studies have examined the temporal stability (i.e., change over time) of these parenting measures. Also, parental characteristics, such as mental health or socio-demographics, may make it more or less difficult to sustain consistent parenting behavior. This study examined the temporal stability of parenting styles and child feeding practices and the association between temporal stability indices with maternal sociodemographic and mental health characteristics. The analytic sample included 161 ethnically diverse mothers enrolled in a six-wave bi-annual longitudinal study. During each wave, mothers reported on their parenting styles and child feeding practices using validated self-report questionnaires. Temporal stability indices for parenting styles were moderate for authoritative (ICC = 0.57) and authoritarian (ICC = 0.70) styles, yet high for permissive (ICC = 0.78) styles. Temporal stability scores for child feeding practices were low for discipline (ICC = 0.33), limit setting (ICC = 0.33), monitoring (ICC = 0.36), and pressure to eat (ICC = 0.34); however, restriction (ICC = 0.53) and role modeling of healthy eating were moderate (ICC = 0.73). Greater income and education status were positively associated with stability in authoritative, authoritarian, and permissive parenting styles, as well as with limit setting, monitoring, role modeling of healthy eating, and pressure to eat feeding practices. Higher anxiety and depressive symptoms and lower self-esteem were negatively associated with permissive parenting styles and role modeling of healthy eating. Findings show that maternal parenting styles and child feeding practices fluctuate over time, and sociodemographic and mental health characteristics are related to stability of some of these parenting styles and behaviors.

The effect of antepartum depressive and anxiety symptoms on mother-infant interaction: The mediating role of antepartum maternal emotional stress

Anxiety disorders, depression, and emotional stress during the antepartum period are interlinked with adverse child development. The quality of the dyadic interaction seems to play a crucial role in the transmission of these effects. In this study, we explored the mediating effect of antepartum maternal emotional stress (assessed via the Prenatal Emotional Stress Index) regarding the relationship of antepartum maternal depressive (assessed via the Edinburgh Postpartum Depression Scale), anxiety symptoms (assessed via the Stat-Trait-Anxiety-Inventory), and depressive and anxiety disorders (assessed according to the DSM-IV-TR) in the antepartum period on postpartum interactive quality in a longitudinal design. The Face-to-Face-Still-Face Paradigm (FFSF) and the Infant and Caregiver Engagement Phases (ICEP-R) coding system were used to assess the postpartum interactive qualities of the mother-infant dyads. The sample consisted of 59 women, 38 in the clinical and 21 in the control group. We found significant indirect effects of antepartum depressive symptoms and maternal diagnostic status on the mother's neutral engagement and on the latency to the first social positive interactive match during the interaction - effects that were mediated by antepartum stress. Moreover, there was an indirect effect of state anxiety on neutral engagement - mediated by antepartum stress. Therapeutic intervention studies focusing on maternal antepartum regulation of emotional stress and postpartum interactive patterns might be crucial to encounter maladaptive developmental trajectories.

Predictors of executive function among 2 year olds from a Thai birth cohort

Executive function (EF) is a critical skill for academic achievement. Research on the psychosocial and environmental predictors of EF, particularly among Southeast Asian, agricultural, and low income/rural populations, is limited. Our longitudinal study explored the influence of agricultural environmental, psychosocial, and temperamental factors on children's emerging EF. Three-hundred and nine farm worker women were recruited during the first trimester of pregnancy. We evaluated the effects of prenatal insecticide exposure and psychosocial factors on "cool" (i.e., cognitive: A-not-B task, looking version) and "hot" EF (i.e., affective, response inhibition) measures of emerging EF. Maternal urine samples were collected monthly during pregnancy, composited, and analyzed for dialkylphosphate (DAP) metabolites of organophosphate insecticides. Psychosocial factors included socioeconomic status, maternal psychological factors, and quality of mother-child behavioral interactions. Backward stepwise regressions evaluated predictors of children's EF at 12 (N = 288), 18 (N = 277) and 24 (N = 280) months of age. We observed different predictive models for cool EF, as measured by A-not-B task, vs. hot EF, as measured by response inhibition tasks. Report of housing quality as a surrogate for income was a significant predictor of emerging EF. However, these variables had opposite effects for cool vs. hot EF. More financial resources predicted better cool EF performance but poorer hot EF performance. Qualitative findings indicate that homes with fewer resources were in tribal areas where children must remain close to an adult for safety reasons. This finding suggests that challenging physical environments (e.g., an elevated bamboo home with no electricity or running water), may contribute to development of higher levels of response inhibition through parental socialization methods that emphasize compliance. Children who tended to show more arousal and excitability, and joy reactivity as young infants in the laboratory setting had better cognitive performance. In contrast, maternal emotional availability was a significant predictor of hot EF. As expected, increased maternal exposure to pesticides during pregnancy was associated with worse cognitive performance but was not associated with inhibitory control. Identifying risk factors contributing to the differential developmental pathways of cool and hot EF will inform prevention strategies to promote healthy development in this and other unstudied rural, low income Southeast Asian farming communities.

The effectiveness of the use of a technology toolkit on activities and mother-child interactions: children with complex care needs

PURPOSE

Meaningful interactions with significant others are crucial for children's well-being, including those with severe to profound intellectual and multiple disabilities. This study aimed to gain more insight into the potential of an ICT-Toolkit in enhancing or contributing to the interaction between parents and their children with complex care needs.

METHODS

A multiple case study with an AB experimental design was conducted. Four mother-child dyads were observed during eight two-and-a-half-hour home visits. Children between 6 and 16 years with severe to profound intellectual and multiple disabilities were included. A participatory research observation approach was used.

RESULTS

Using the ICT-Toolkit compared to the baseline phase stimulated a decrease in the repetitive activities of two of the four dyads. Overall, the activity repertoire of the children and the length of time being engaged in individual activities increased, and the activities together increased in three of the dyads. There were more turn-taking interactions; the children took more initiative to engage their mother in their activity, and the children exhibited more affection when engaging with the ICT-Toolkit items. Three mothers followed their children more in their play, and all mothers were more verbally and physically active in instructing and/or motivating their children.

DISCUSSION

All mothers noticed their child's "new" behaviour when interacting with an ICT-Toolkit item. The mothers followed the child's lead when engaged with the ICT-Toolkit. The ICT-Toolkit's added effect may be due to the predictability, uncomplicated and highly perceivable stimuli it provides with minimal effort and maximum effect.

Turn-taking in free-play interactions: A cross-sectional study from 3 to 5 years

Turn-transition timing in childhood has been examined by measuring response latency - that aggregates gap and overlap duration - in turn-transitions contingent to specific semantic categories. This contrasts with studies in infancy where the whole spectrum of temporal contingent vocalizations are examined, and gap and overlap duration is analyzed independently. We propose using the latter approach to investigate the continuities between infancy and childhood. In a cross-sectional design, we analyzed the vocalizations of 44 mother-child free-play interactions, ranging from three to five years of age. Frequency and duration were measured for gaps and overlaps, independently, and as an aggregated measure - floor-transfer offset (FTO). The effects of child's age and direction of turn-transition (child, mother) were assessed using generalized linear mixed modeling for each dependent variable (DV: FTO, gaps, overlaps). Although there was a slight increase in FTO and gap duration across ages, no significant effect of age was found for any of the DVs. There was an effect of turn-transition direction, for FTO and gap durations, but not for overlap duration. Specifically, mother-to-child turn-transitions produced significantly longer FTO and gap durations than child-to-mother turn-transitions, but had similarly timed overlaps. Results suggest that gaps and overlaps still have different developmental trajectories throughout childhood, and that overlap duration converges to adult standards, at least, by 3-years of age. Methodologically, we demonstrated the relevance of using complementary metrics (FTO, gap, overlap) to understand the developmental trajectories of turn-taking, and that examining all temporally contingent vocalizations can provide a valid and more inclusive measure of turn-transition duration in childhood.

Strengthening mother-child interactions among mothers and children with behavior problems at early development

The present study examined the effectiveness of a personalized remote video feedback parenting program to improve mother-child interactions and child behavior outcomes among mothers of children with behavior problems in comparison to counterparts with no behavior problems. The sample comprised 60 mothers and their 2-to-6-year-old children, including children with behavior problems (BP = 19) and children without behavior problems (NoBP = 41). The Strengthening Bonds program included one in-person group session and remote personalized video feedback about their mother-child interactions in a play situation via smartphone for six weeks. Mother-child interactions were the primary outcome, and children's behaviors were the secondary outcome. Pre- and post-intervention assessments were performed. The mother-child interactions were recorded during free- and structured-play situations and were then analyzed by the Parenting Interactions with Children: Checklist of Observations Linked to Outcomes (PICCOLO) and the Dynamics of the dyad activity coding system. Additionally, the mothers answered the Strengths and Difficulties Questionnaire. The results showed that, in the post-intervention, the mother-child interaction pattern improved in the BP group, especially in the teaching dimension of the PICCOLO. Also, after the program, more children with normal classification were in the BP group.

Transactional relationships between maternal requesting and responsivity, adolescent compliance, and task demands in fragile X syndrome

BACKGROUND

Males with fragile X syndrome (FXS) may have difficulty with social communication and language in addition to behavioral concerns such as noncompliance to maternal requests. Mothers vary in how they pose requests to their children, and contextual demands may also be a factor in compliance. This study examined the relationships between maternal requesting behaviors, maternal responsivity, child compliance, and task demands in adolescent males with FXS.

METHODS

35 mother-son dyads completed three interactive tasks during in-home visits (puzzle, iPad games, snack). The adolescents also completed assessments of language and autism symptoms. The three interactive tasks were video-recorded, and behavior-by-behavior coding and transcription was completed.

RESULTS

Comparing between tasks, mothers requested a behavior most often during the snack task and used a higher proportion of indirect requests during the iPad task. Adolescents were largely compliant across tasks, with average compliance equal to 70%. Adolescent compliance was predicted by maternal request frequency such that mothers who used more requests had adolescent sons who were less compliant. Maternal responsivity was higher for mothers of adolescents with FXS-only compared to those with FXS and high autism symptoms.

CONCLUSIONS AND IMPLICATIONS

Task demands may have influenced maternal requesting, which in turn may have impacted adolescent compliance. Compliance with requests is important for both social and educational aspects of life, and further study of requesting and compliance in FXS is needed to identify effective teaching and behavioral intervention methods.

Mother and father interaction with their 3-month-old infants: Similarities and differences in parenting behaviour in well-resourced parents

Infancy is characterized by intensive parenting which may affect later child development. However, little is known about similarities and differences in maternal and paternal parenting behaviour, as the majority of the studies have mainly focused on mothers. The present study investigated similarities and differences in mothers' and fathers' parenting behaviour during parent-infant interaction in 56 mothers and 56 fathers of 3-months-old infants in a good-resourced sample. Parent-child interactions were videotaped and coded by the Global Rating Scales. Results suggested similar parenting behaviour in terms of maternal and paternal sensitivity, intrusiveness and remoteness. Moreover, regardless of sex infant's behaviour was similar during interactions with mothers and fathers. The low-risk and non-clinical nature of our sample may have had a positive influence on mother-child and father-child dyadic exchanges. These findings suggest including family system models in research and clinical practice.

Relationship between Borderline Personality Disorder, Emotional Availability, and Cortisol Output in Mother-Child Dyads

BACKGROUND

Mothers with borderline personality disorder (BPD) often show altered emotional availability toward their own child and heightened stress vulnerability. The aims of the present study were (1) to examine total cortisol output in saliva during mother-child interaction in mothers with BPD and their children and (2) to test whether maternal nonhostility as a subscale of emotional availability mediates the relationship between maternal BPD and child total cortisol output.

METHODS

We investigated 16 mothers with BPD and 30 healthy control mothers (HC) and 29 children of mothers with BPD and 33 children of HC mothers. Children were between 5 and 12 years old. Salivary cortisol was collected prior to and twice after an episode of a 21-min standardized play situation between mother and child. Nonhostility was rated using the emotional availability scales. Analyses of covariance were computed to test for group differences in total cortisol output (measured with area under the curve with respect to ground). Pearson's correlation was calculated to test the association between maternal and child total cortisol output. To test the second question, a mediation analysis according to Preacher and Hayes was conducted.

RESULTS

Mothers with BPD and their children had lower total cortisol output. Maternal and child total cortisol output was significantly correlated. Contrary to our hypothesis, maternal nonhostility did not mediate the relationship between BPD and child total cortisol output.

CONCLUSION

Results imply that the hormonal stress activity of mothers with BPD and their children is altered, which may reflect modified stress regulation and stress vulnerability in mother and child and may impact on mother-child interaction. The finding of a positive association between mother's and child total cortisol output could indicate an intergenerational transmission of these alterations.

Impact of COVID-19 lockdown on maternal psychological status, the couple's relationship and mother-child interaction: a prospective study

BACKGROUND

To compare the rate of postpartum depression (PPD) during the first COVID-19 lockdown with the rate observed prior to the pandemic, and to examine factors associated with PPD.

METHODS

This was a prospective study. Women who gave birth during the first COVID-19 lockdown (spring 2020) were offered call-interviews at 10 days and 6-8 weeks postpartum to assess PPD using the Edinburgh Postnatal Depression Scale (EPDS). Post-traumatic symptoms (Perinatal Post-traumatic Stress Disorder Questionnaire, PPQ), couple adjustment, and interaction and mother-to-infant bonding were also evaluated. The observed PPD rate was compared to the one reported before the pandemic. Factors associated with an increased risk of PPD were studied. The main outcome measures were comparison of the observed PPD rate (EPDS score > 12) to pre-pandemic rate.

RESULTS

Of the 164 women included, 27 (16.5% [95%CI: 11.14-23.04]) presented an EPDS score > 12 either at 10 days or 6-8 weeks postpartum. This rate was similar to the one of 15% reported prior to the pandemic (p = 0.6). Combined EPDS> 12 or PPQ > 6 scores were observed in 20.7% of the mothers [95%CI: 14.8-0.28]. Maternal hypertension/preeclampsia (p = 0.007), emergency cesarean section (p = 0.03), and neonatal complications (p = 0.008) were significantly associated with an EPDS> 12 both in univariate and multivariate analysis (OR = 10 [95%CI: 1.5-68.7], OR = 4.09[95%CI: 1.2-14], OR = 4.02[95%CI: 1.4-11.6], respectively).

CONCLUSIONS

The rate of major PPD in our population did not increase during the first lockdown period. However, 20.7% of the women presented with post-traumatic/depressive symptoms.

TRIAL REGISTRATION

NCT04366817.

How do maternal emotional regulation difficulties modulate the mother-infant behavioral synchrony?

Mother-infant synchrony is one of the most important processes in the development of socio-affective competencies in children. While maternal abilities and psychopathology are related to maladaptive mother-infant synchrony, it is as yet unclear how maternal emotion regulation difficulties contribute to it. Based on a panel of behavioral indicators (i.e., gaze, vocal, and motor), the present study examined mother-infant synchrony at 6 months of age in a modified version of Ainsworth's Strange Situation (n = 72 dyads). Mother-infant interaction sequences were characterized by indicators of complexity (LZ complexity of joint behavioral sequences) and of synchronization quality (cross-recurrence plot quantification). Results showed that mothers' touch was greater in the reunion condition than in the initial condition. Mothers' motor behaviors were associated with the global levels of infants' behavioral involvement in the reunion condition, unlike the symmetrical influence observed between mothers and infants in the initial condition. Results show that maternal anxiety mediates the relationships between mothers' emotion regulation difficulties and gaze, vocal, and motor synchrony between mothers and infants in the initial and reunion conditions. This study emphasizes the central role of maternal emotion regulation difficulties in the establishment of maladaptive synchrony and in the adjustments of maternal physical contacts with infants.

Maternal depressive symptoms and maternal child-directed speech: A systematic review

BACKGROUND

Up to 1 in 5 children are exposed to maternal depressive symptoms. Children exposed to maternal depressive symptoms have poorer language skills than children not exposed to maternal depressive symptoms. Due to the crucial role of children's language skills in school readiness and academic achievement, it is imperative to understand the factors that underlie the relation between maternal depressive symptoms and children's language skills. Previous reviews have examined the mechanistic role of social-pragmatic features of mother-child interactions. However, the literature on the relation between maternal depressive symptoms and data-providing aspects of mother-child interactions, including child-directed speech, has yet to be consolidated. In this systematic review, we present maternal child-directed speech as a potential pathway through which maternal depressive symptoms influence children's language skills.

METHODS

Following PRISMA guidelines, three database searches produced 546 articles related to maternal depressive symptoms, child-directed speech, and children's language skills, ten of which examined the relation between maternal depressive symptoms and child-directed speech.

RESULTS

Findings revealed that increases in maternal depressive symptoms may be associated with decreases in amount of child-directed speech but not necessarily with decreases in the complexity of child-directed speech.

LIMITATIONS

The studies in this review varied in sample size, the inclusion of important sociodemographic factors, and the operationalization of depression and child-directed speech, thereby limiting conclusions, especially about whether maternal depressive symptoms are associated with the complexity of child-directed speech.

CONCLUSIONS

This review has implications for prevention and intervention efforts aimed at optimizing children's language skills; child-directed speech is modifiable, and mothers experiencing depressive symptoms may benefit from resources encouraging rich child-directed speech.

Effects of self-healing intervention on quality of life and mother-child interaction among female breadwinners

OBJECTIVES

This study aimed to investigate the effectiveness of self-healing (the healing codes) intervention on quality of life (QoL) and mother-child interaction among female breadwinners.

METHODS

The study population comprised all female breadwinners who referred to the welfare centers of Isfahan in 2020; using convenience sampling, we selected 30 women and divided them into experimental and control groups (n = 15 per group). The experimental group underwent fourteen sessions (90-min sessions per week) of self-healing training.

RESULTS

The mean ± SD of QoL and mother-child interaction for experimental and control groups in the post-test stage were 84.33 ± 3.92 and 160.86 ± 8.74 respectively. Self-healing intervention had significant effects on QoL and mother-child interaction among female breadwinners. The intervention program improved the components of QoL and mother-child interaction among female breadwinners (p < 0.01).

CONCLUSIONS

Self-healing training can be used as a novel approach to enhance QoL and mother-child interaction in this group of women.

Mother-Infant Interaction Kinect Analysis (MIIKA): An automatic kinematic-based methodology for the investigation of interpersonal distance during early exchanges

Interpersonal distance is a core aspect of mother-child interaction. While conventional measures based on human coders do not fully capture the dynamics of this feature, computational methods provide automatic measures which can detect even small changes and more accurate estimates both spatially and temporally. Using RGB-D sensors (Microsoft Kinect V2), the present study describes a setup to automatically examine interpersonal distance during mother-child interactions, termed Mother-Infant Interaction Kinect Analysis (MIIKA). First, the laboratory setting and the data extraction method are described. By using an ad-hoc algorithm for kinematic data extraction, MIIKA returns three metrics: barycenter position (distance and velocity of approach and separation), movements (number of small, medium and large approaches and separations) and contributions (proportional contributions of mother and child to approaches and separations). Secondly, preliminary MIIKA metrics are described for a non-clinical mother-child dyad as an exemplification of the protocol. As interpersonal distance can be affected by contingent situations, we detected mother-infant full skeleton during three interactional contexts characterized by different kinds of dyadic exchanges: a free play session, a task-oriented activity and an emotionally arousing condition. Results highlighted similarities and differences between the three interactional contexts. MIIKA appears to be a promising setup to automatically examine interpersonal distance in early mother-child interactions.

Concordance of mother-child respiratory sinus arrythmia is continually moderated by dynamic changes in emotional content of film stimuli

Evidence suggests that concordance between parent and child physiological states is an important marker of interpersonal interaction. However, studies have focused on individual differences in concordance, and we have limited understanding of how physiological concordance may vary dynamically based on the situational context. We examined whether mother-child physiological concordance was moderated by dynamic changes in emotional content of a film clip they viewed together. Second-by-second estimates of respiratory sinus arrythmia were obtained from mothers and children (N = 158, M_{child age} = 45.16 months) as they viewed a chase scene from a children's film. In addition, the film clip's negative emotional content was rated second-by-second. Results showed that mother-child dyads displayed positive physiological concordance only in seconds when there was an increase in the clip's negative emotional content. Thus, dynamic changes in mother-child physiological concordance may indicate dyadic responses to challenge.

Delivery room skin-to-skin contact in preterm infants affects long-term expression of stress response genes

Premature birth is a traumatic event that puts mother and child at risk for subsequent psychopathology. Skin-to-skin contact in the form of intermittent kangaroo mother care has been shown to positively affect the infant's stress response and cognitive development, but underlying mechanisms remain unclear. Moreover, first skin-to-skin contact is usually delayed for days after birth. In the delivery room skin-to-skin study (DR-SSC), a prospective randomized controlled trial conducted from 2/2012 to 7/2015, we set out to assess the effect of delivery room skin-to-skin contact on the infant's mRNA expression of six key molecules involved in stress response and neurobehavioral development at hospital discharge. 88 firstborn, singleton preterm infants (born at 25-32 weeks of gestational age) were included. In the delivery room after initial stabilization, infants were randomized to either 60 min of skin-to-skin or 5 min of visual contact with their mother. In this explorative add-on study on the original DR-SSC study, we determined the expression of six important stress response genes (CRHR1 and CRHR2, AVP, NR3C1, HTR2A, and SLC6A4) in peripheral white blood cells of infants during routine blood sampling upon hospital discharge (corrected gestational age of 40 weeks). Infants were followed up to six months corrected age. Relative mRNA expression of the corticotropin releasing hormone receptor 2 (CRH R2), the glucocorticoid receptor gene (NR3C1), and the serotonin transporter gene (SLC6A4) was significantly reduced in the delivery room SSC infants. Additionally, gene expression of CRH R2 showed a correlation with HPA axis reactivity and parameters of mother-child interaction at six months corrected age. Our results highlight the importance of delivery room mother-child skin-to-skin contact and underline the urgent need for in-depth studies on the underlying molecular mechanisms.

Prematurity and Maladaptive Mealtime Dynamics: the Roles of Maternal Emotional Distress, Eating-Related Cognitions, and Mind-Mindedness

Premature birth and maternal emotional distress constitute risk factors for feeding disorders. This study examined the roles of maternal cognitions in the link between prematurity, emotional distress and mother-infant maladaptive mealtime dynamics in a sample of 134 families (70 preterm, low medical risk; 64 full-term) followed longitudinally. Specifically, maternal cognitions related to eating and health (perception of child vulnerability and concerns about child's eating) and understanding of mental states (interactional mind-mindedness) were considered. A multiple-mediators model was tested, controlling for infants' weight and breastfeeding history. Although prematurity did not directly predict mealtime dynamics, multiple-mediation analyses revealed indirect pathways: mothers of preterm newborns reported higher emotional distress, which subsequently predicted perception of child vulnerability and concerns about child's eating at 6-months; perception of child vulnerability predicted more conflictual mealtime dynamics, whereas concern about child's eating predicted less reciprocal mealtime dynamics at 12-months. Mind-mindedness at 6-months predicted more reciprocal and less conflictual mealtime dynamics but did not act as a mediator. Implications for understanding pathways from prematurity to feeding disorders are discussed.

Do developmental and temperamental characteristics mediate the association between preterm birth and the quality of mother-child interaction?

BACKGROUND

The current study aims to evaluate the association between preterm birth and the quality of mother-child interaction of very preterm-, moderate preterm-, and full-term-born children at 18 and 36 months and to determine whether developmental and behavioral characteristics mediate the association between preterm birth and the quality of mother-child interaction.

METHOD

Participants included 110 preterm-born children and 39 full-term-born children assessed at ages 18 and 36 months. Mother-child free play interactions, the Mullen Scales of Early Learning, the Infant Behavior Questionnaire, and the Early Childhood Behavior Questionnaire were administered.

RESULTS

Significant associations between preterm birth and the quality of mother-child interaction were found at 18 and 36 months. The mother-child interaction quality was less optimal for the preterm-born children compared with the full-term-born children, mainly so for the very preterm-born children. Unlike behavioral characteristics, cognitive development was found to mediate the association between the gestational age-based group and the quality of mother-child interaction.

CONCLUSIONS

Intervention programs for preterm-born children and their families, should consider maternal and children's behaviors during mother-child interactions, in addition to cognitive, language, motor and emotional regulation abilities, and particularly so with very preterm-born children, who exhibit slower cognitive development.

Understanding the role and function of maternal touch in children with neurodevelopmental disabilities

During the first years of life, maternal touch can serve different functions including facilitation of child's gaze orientation to faces which is a key precursor for social attention. Although children with neurodevelopmental disability (ND) may have reduced social skills, the role of maternal touch in contributing to gaze orientation to maternal face has not been explored in previous research. In the present study, we investigate the functions of maternal touch in dyads of mothers and children with ND, compared to dyads of children with typical development (TD). Micro-analytic 2-s coding of maternal touch (i.e., affectionate, playful, facilitating, holding, no touch) and children's gaze orientation (i.e., mother-oriented, object-oriented, non-oriented) occurred during 5-minute interactions between mothers and their 12-to-24-month-old ND and TD children. Dyads were paired for children chronological age and sex. Mothers of children with ND used more touch - especially facilitating and holding types -, compared to mothers of TD peers. Children with ND exhibited more non-orientated gaze compared to TD counterparts. Playful touch associated with increased mother-oriented gaze in children with ND, whereas affectionate and holding touch associated with greater mother-oriented gaze in TD children. Findings suggest that specific types of touch support children's attention to social partners.

The Cycle of Abuse: Emotional Availability in Resilient and Non-Resilient Mothers with Early Life Maltreatment

BACKGROUND

Early life maltreatment (ELM) has a high risk of transmission across generations, known as "the cycle of abuse." ELM is also an important risk factor for developing mental disorders, and having a mental disorder increases the risk of child abuse. Both the abuse potential in mothers with ELM and in mothers with a history of mental disorders might be associated with a disturbed mother-child interaction.

OBJECTIVE

The current study examined differences in emotional availability between mothers with a history of ELM and previous or current mental disorders (non-resilient), mothers with ELM without mental disorders (resilient), and control mothers without ELM and without mental disorders.

METHODS

Thirty-three non-resilient mothers, 18 resilient mothers, and 37 control mothers and their 5- to 12-year-old children participated in a standardized mother-child interaction task. Videotaped interactions were rated by three independent, trained raters based on the Emotional Availability Scales (EA Scales) and compared between the groups.

RESULTS

The non-resilient mothers and their children showed reduced maternal sensitivity, structuring, non-intrusiveness, non-hostility, responsiveness, and involvement compared to the resilient mothers and their children and the control mothers and their children (p = 0.006, ηp2 = 0.12). No differences on any of the EA Scales were found between resilient mothers and control mothers.

CONCLUSIONS

These deficits in mother-child interaction in non-resilient mothers might contribute to mechanisms that could explain the cycle of abuse. Interestingly, resilient mothers, who did not develop a mental disorder despite having experienced ELM, did not show these deficits. Thus, prevention programs promoting resilience might be a key to break the cycle of abuse.

Mother-child and siblings' mediated learning strategies in families with and without children with intellectual disability

The objectives of the research were to study differences in Mediated Learning Experience (MLE) strategies between mothers and their children in families with intellectually disabled and typically developing children and the cross-generation transmission of MLE strategies. Dyads of mother-child and siblings were observed interacting in free-play and teaching situations and their mediation strategies were analyzed by the Observation of Mediation Interaction scale. The child in the mother-child interaction was the older sibling in the siblings' interaction. Siblings samples were composed of two main groups: where the younger sibling (a) had an intellectual disability (ID, n = 25), or typically developing sibling dyads matched on (b) difference in mental age (TDM, n = 25) and (c) difference in chronological age (TDC, n = 25). The mediation strategies of older-younger siblings were compared to that of mother-child (with older sibling). The findings showed that siblings demonstrated higher level of MLE strategies than mothers in the ID group as compared with the two TD groups and that there is a cross-generation transmission of MLE strategies after controlling variables of group, mothers' years of education, level of occupation, and level of religiosity. The findings implications are related to the central role of siblings in families with a child with ID and working with families to enhance children's cognitive development.

Exposure to early and persistent maternal depression impairs the neural basis of attachment in preadolescence

Maternal depression increases child vulnerability to psychopathology, loneliness, and social maladjustment; yet, its long-term effects on the social brain are unknown. In this prospective longitudinal study we examined the impact of early and persistent maternal depression on the neural basis of attachment in preadolescence. A community cohort was followed in two groups; children exposed to maternal depression from birth to 6 years and healthy controls. At 9 months and 6 years, mother-child interactions were coded for maternal sensitivity and affect synchrony and salivary oxytocin levels were assessed at 6 years. At preadolescence (11-13 years), children underwent magnetoencephalography (MEG) while exposed to own versus unfamiliar mother-child interaction. Own interaction elicited greater response in beta- and gamma-band oscillations across a wide cluster in temporal and insular cortices, including the Superior Temporal Sulcus, Superior Temporal Gyrus, Inferior Temporal Gyrus, and insula. Beta activations were predicted by maternal sensitivity across early childhood and gamma by affect synchrony. Oxytocin was related to beta response to social cues. Maternal depression impacted child's brain response in two ways. First, maternal depression significantly increased the prevalence of child affective disorder and such children showed no neural differentiation between attachment and non-attachment stimuli. Second, maternal depression decreased maternal sensitivity, affect synchrony, and child oxytocin across early childhood and these were longitudinally associated with aberrant neural response to attachment-specific and social-general cues in preadolescence. Our findings are the first to describe mechanisms by which maternal depression impairs the neural basis of attachment at the transition to adolescence and advocate the need for relationship-focused early interventions.

Mother-child interaction: implications of chronic maternal anxiety and depression

Background

The literature has few studies on the quality of the mother-child interaction when mothers suffer from chronic anxiety and depression. This study aimed to compare characteristics of the interaction between 14-month-old children and their mothers who presented symptoms of chronic anxiety or depression with those of 14-month-old children and their mothers who did not present mental problems.

Method

The sample consisted of 40 mother-infant dyads selected from a prospective cohort study. They were assessed using the State-Trait Anxiety Inventory and the Beck Depression Inventory, at three time points: during pregnancy and at 6 months and 14 months of the infant’s life. Three groups were formed: 10 mothers with symptoms of chronic anxiety, 8 mothers with symptoms of chronic depression, and a control group of 22 mothers without mental health problems. The mothers responded to a socioeconomic questionnaire, and then a 7-min episode of the dyad interaction was recorded and assessed using categories indicated in a dyadic interaction assessment protocol. This consisted of six categories that evaluate the behavior of the caregiver and four categories that evaluate the child’s behavior.

Results

A significantly higher percentage of mothers with chronic depressive symptoms had not completed high school and did not live with a partner. When comparing the interaction behaviors of the three groups, mothers with symptoms of chronic depression were significantly less sensitive, were more disengaged, and showed less positive affect than those in the control group. They also engaged in significantly fewer stimulations and displayed more negative affect compared with both the control group and mothers with chronic anxiety symptoms. Anxious mothers presented greater intrusiveness compared with mothers in the control group. Regarding the children, those with mothers showing symptoms of chronic depression interacted significantly less than those with mothers showing symptoms of chronic anxiety and the control group.

Conclusions

The results indicate that mother-infant interaction is most severely compromised among mother-infant dyads comprised of mothers with chronic depressive symptoms, compared with dyads of mothers with chronic anxiety symptoms and dyads of control group mothers without mental health problems.

The influence of the family environment on adaptive functioning in the classroom: A longitudinal study of children with developmental disabilities

BACKGROUND

No study has examined trajectories of school-based adaptive functioning (AF) for children with developmental disabilities (DD). This is a critical gap in the literature, since AF is context dependent, and high levels of AF at school facilitate meaningful participation at school.

AIMS

This study examined trajectories of school-based AF for 170 children with DD from age 3 to 15 years, and indicators of the early childhood home and family environment as predictors of these trajectories.

METHODS

Multilevel modeling was used to explore trajectories of school-based AF and identify early childhood home and family predictors of these trajectories.

RESULTS

Children's school-based AF raw scores increased over time. There was significant variability in initial status and rate of change of AF. As hypothesized, higher quality mother-child interaction predicted more positive functioning.

CONCLUSIONS

Findings indicate the influence of the early childhood home and family environment on school-based AF over time.

[Mental health of teenage mothers: impact on the next generation]

BACKGROUND

Motherhood in adolescence is associated with risks for both the young mother and the children.

OBJECTIVE

Presentation of the current state of research on the mental health of adolescent mothers and its effects on the development of their children.

MATERIAL AND METHODS

Electronic database search in PubMed using various combined key terms such as "teenage pregnancy", "adolescent pregnancy", "teenage mother", "child development", "mother-child interaction". Review of the literature of the sources found and discussion of current publications and databases of public institutions.

RESULTS

In addition to psychosocial risks such as fewer education years due to family formation and lower incomes, young mothers also suffer more frequently from mental disorders, both before pregnancy and due to the additional burden of motherhood in their own developmental phase of youth. These can have unfavorable effects on the mother-child interaction and on the psychosocial and cognitive development of the children, thereby leading to the transgenerational transmission of risk factors.

CONCLUSION

In addition to primary prevention by avoiding teenage pregnancies, early identification of adolescent mothers and children at risk for early treatment and intervention is necessary.

Effects of a Maternal Role Adjustment Program on First-time Mothers

PURPOSE

To investigate the effect of a maternal role adjustment program on first-time mothers.

METHODS

The research was quasi-experimental with a non-equivalent control group non-synchronized design. Participants were first-time mothers admitted to two postpartum clinics at women's hospitals. The experimental group had 38 mothers and the control group had 35 mothers. A maternal role adjustment program was applied individually to the experimental group between the 1st and 2nd weeks after childbirth. Assessing Adaptation to Motherhood, Semantic Differential Scale-Myself as Mother, and Edinburgh Postnatal Depression Scale were used to measure effects of the program. A pre-test was conducted in the 1st week after childbirth while post-tests were conducted in the 4th and 6th weeks. Data were analyzed with χ2 test, Fisher's exact test, t-test, and repeated measures ANOVA using SPSS 24.0.

RESULTS

Maternal role adjustment (F=6.17, p=.015) and maternal identity (F=6.63, p=.012) were significantly increased in the experimental group compared to those in the control group. However, the difference in postpartum depression (F=1.11, p=.335) was not statistically significant between the two groups.

CONCLUSION

The maternal role adjustment program can be utilized as an effective nursing intervention program to enhance maternal role adjustment and maternal identity for first-time mothers.

Mothers with acute and chronic postpartum psychoses and impact on the mother-infant interaction

BACKGROUND

Maternal postpartum psychoses pose a serious risk to the mother-infant interaction. It is unclear how different subtypes of postpartum psychosis, including acute and chronic, might differentially affect the mother-infant interaction.

METHOD

A systematic search of electronic journal databases was performed.

RESULTS

This systematic review yielded 17 studies with adequate overall study quality. They focused on child custody and involvement of social services as indirect indicators of the mother-infant interaction, observed mother-infant interactions as direct indicators, or potential transitional mechanisms, including memory processing, mind-mindedness, and affect recognition, that may partially explain the effects of psychotic disorders. An acute onset of psychosis during the postpartum period (de novo or relapse) was typically related to better mother-infant interactions. Mothers with schizophrenia have the highest risk of child displacement, and interventions by social services were more likely. However, mothers with postpartum schizophrenia did not exhibit more harm to the child or self-harm than mothers with postpartum depression. Heterogeneity of methodology, case definitions, and assessments characterized the studies; hence, they were not pooled.

CONCLUSIONS

In addition to evaluating social risk factors in patients with acute onset and chronic psychoses during the postpartum period, negative preconceptions about motherhood and schizophrenia have to be carefully examined. Clinical research on postpartum psychoses should consider the onset criteria, prevalence of self-harm or harm to the child, significance of specific (e.g., religious) delusions and expressed hostility toward the child. More studies on the impact of first-onset (de novo) postpartum psychoses on the mother-infant interaction are needed.

Temporal Responsiveness in Mother-Child Dialogue: A Longitudinal Analysis of Children with Normal Hearing and Hearing Loss

Dialogue between conversational partners, including mothers and their children, is precisely timed. The predictability of this timing is important for establishing and maintaining interaction, communication, and learning. This longitudinal study examines changes in the response latency of utterances in dialogue between mothers and their normal hearing and hearing impaired children between 4 and 60 months of age. Mothers and their children showed parallel developmental trends, responding to each other more quickly at older ages. Beyond these age-related group effects, significant dyadic effects were found in which individual children's latencies were related to those of their mothers, and vice versa. Developmental patterns did not significantly differ across hearing status groups, which may reflect the role of early identification and intervention in promoting positive developmental outcomes.

Emotional availability in mothers with borderline personality disorder and mothers with remitted major depression is differently associated with psychopathology among school-aged children

BACKGROUND

Both, maternal borderline personality disorder (BPD) and maternal major depressive disorder (MDD) are often associated with adverse consequences for children, including increased risk for child behavior problems. Reduced maternal emotional availability might play a critical role in transmitting maternal psychopathology on the child. Our aim was to investigate the association between emotional availability and maternal BPD and MDD in remission (rMDD), and if this interrelatedness mediates the association between maternal mental disorders and child behavior problems.

METHODS

The interaction of 178 mother-child dyads was assessed during a play situation using the Emotional Availability Scales. Children were between 5 and 12 years old. Regression analyses were used to investigate the impact of maternal BPD and maternal rMDD on emotional availability. Ordinary least squares regression analyses using bootstrapping were conducted to investigate the mediating effect of emotional availability on the association between maternal mental disorders and child behavior problems.

RESULTS

Mothers with BPD showed increased hostility during mother-child interaction, whereas history of MDD was associated with reduced sensitivity. Maternal hostility was a mediator between maternal BPD and number of child psychiatric disorders, as well as externalizing and internalizing behavior. Maternal sensitivity mediated the association between maternal rMDD and number of child psychiatric disorders, as well as internalizing child behavior.

CONCLUSIONS

Our data suggest that mothers with BPD show a qualitatively different pattern of emotional availability compared to mothers with rMDD. These patterns might reflect two separate pathways of transgenerational transmission of aspects of maternal mental disorders, where intervention and training programs could start: maternal rMDD impacts on child behavior problems via reduced sensitivity, and maternal BPD via increased hostility, which could both be addressed with specific therapeutic interventions.

Reliable and Valid Coding of Thin Slices of Video Footage: Applicability to the Assessment of Mother-Child Interactions

When using behavioral-observation methods for coding video footage, it is unknown how much time of an interaction needs to be coded to gain results that are representative for the behavior of interest. The current study examined this problem using the INTAKT, a standardized observational measure for assessing the quality of mother-child interactions. Results from coding only 10 min of each video (i.e., thin slices) were compared with results from coding the remaining parts (averaging about 40 min) of the interaction. Inter-rater agreement for the short versions taken from the beginning or the middle, but not the end of the interactions indicated satisfactory observer accuracy. Coding results did not differ between short and long video sequences, when sequences were taken from the middle of the interactions. Importantly, characteristic differences between different interactive situations were equally well represented in the short and long video sequences. Therefore, our results show that coding only 10 min of an interaction is as reliable and valid as coding full-length videos, if those short sequences are taken from the middle of an interaction. Our findings support the idea that for every method, it is necessary to individually determine the window duration that is long enough to gain results that are reliable and valid.

Mother-child interaction is associated with neurocognitive outcome in extremely low gestational age children

Early mother-child interaction is one of the factors suggested to have an impact on neurocognitive development of extremely low gestational age (ELGA) children. Our aim was to examine associations of mother-child interaction with neurocognitive outcome, neurological impairments and neonatal brain injuries in ELGA children. A prospective study of 48 ELGA children, born before 28 gestational weeks (26.3 ± 1.2 weeks, birth weight 876 g ± 194 g), and 16 term controls. Brain MRI was performed at term-equivalent age. At two years of corrected age, the mother-child interaction was assessed in a structured play situation using the Erickson Scales and Mutually Responsive Orientation Scales. Neurocognitive outcome was assessed with Griffiths Mental Developmental Scales (GMDS) and Bayley Scales of Infant and Toddler Development - Third Edition (BSID-III) and with Hempel neurological examination. Among ELGA children, higher quality of dyadic relationship and maternal sensitivity, responsiveness, and supportiveness were associated with positive neurocognitive outcome measured both with GMDS and BSID-III (adjusted p < 0.05). This association remained after adjusting for mother's educational level. Neurological impairments at two years, white matter or gray matter abnormalities in MRI at term-equivalent age, and grade III-IV intraventricular hemorrhage during the neonatal period were not associated with mother-child interaction. This study emphasizes the importance of the quality of mother-child interaction after extremely preterm birth for neurocognitive development. Neonatal brain injury and neurological impairments were not associated with worse parent-child interaction after two years.

How mothers interact with children with suspected cow's milk allergy symptoms

AIM

To characterize mother-child interaction in children with suspected gastrointestinally manifested cow's milk allergy (GI-CMA) and to explore factors associated with the parentally perceived symptoms.

METHODS

We invited a randomly selected group of children with suspected GI-CMA and their mothers to take part in a video recording of them playing together. The mother-child interaction was rated using the Emotional Availability Scales (EAS, 4th edition) and compared with national normative data.

RESULTS

Video recordings were conducted with 24 patients (15 girls and nine boys) with a median age of 10.1 months (range 2.1-20.5 months) undergoing a double-blind, placebo-controlled food challenge for cow's milk allergy. The EAS profile in the challenge negative group (17/24) was significantly different from the normative data. The scores for maternal sensitivity (p = 0.0049) and nonintrusiveness (p = 0.0192), together with child responsiveness (p = 0.0053) and involvement of mother (p = 0.0085), were all significantly lower when compared to the normative data. The dimensions of maternal nonhostility and structuring, as well as the scores of the challenge positive group, did not differ from the normative data.

CONCLUSION

Dysfunctional mother-child emotional interaction was frequent in young children with suspected GI-CMA ruled out by the cow's milk challenge. Appropriate psychological support should be considered.

Parent behaviors moderate the relationship between neonatal pain and internalizing behaviors at 18 months corrected age in children born very prematurely

Children born very preterm (≤ 32 weeks gestation) exhibit greater internalizing (anxious/depressed) behaviors compared to term-born peers as early as 2 years corrected age (CA); however, the role of early stress in the etiology of internalizing problems in preterm children remains unknown. Therefore, we examined the relationship between neonatal pain and internalizing behavior at 18 months CA in children born very preterm and examined whether parent behavior and stress moderated this relationship. Participants were 145 children (96 very preterm, 49 full term) assessed at 18 months CA. Neonatal data were obtained from medical and nursing chart review. Neonatal pain was defined as the number of skin-breaking procedures. Cognitive ability was measured with the Bayley Scales of Infant Development II. Parents completed the Parenting Stress Index III, Child Behavior Checklist 1.5-5, and participated in a videotaped play session with their child, which was coded using the Emotional Availability Scale IV. Very preterm children displayed greater Internalizing behaviors compared to full-term control children (P=.02). Parent Sensitivity and Nonhostility moderated the relationship between neonatal pain and Internalizing behavior (all P<.05); higher parent education (P<.03), lower Parenting Stress (P=.001), and fewer children in the home (P<.01) were associated with lower Internalizing behavior in very preterm children, after adjusting for neonatal medical confounders, gender, and child cognitive ability (all P>.05). Parent Emotional Availability and stress were not associated with Internalizing behaviors in full-term control children. Positive parent interaction and lower stress appears to ameliorate negative effects of neonatal pain on stress-sensitive behaviors in this vulnerable population.